What to Take for a Cold | What's in that Bottle of OTC Cough Medicine?

A lot cough and cold medicines position themselves as multi-symptom, and contain several different active ingredients, a kind of shotgun approach to cold relief. You know, that whole “sniffling, sneezing, coughing, aching...” business. I don't like to take more medicine than I need and I think some of these combinations make me feel weird and even work against each other, so I tend to choose a medication with only 1, or at most 2, ingredients that target my worst symptoms. I'm a label reader and I've done a little research on some of the most common ingredients in over-the-counter cold and cough medicines.

Acetaminophen is one of the most common ingredients in over the counter cough medicines, it is the active ingredient in Tylenol. Acetaminophen is used to treat mild pain and fever. If you are taking a medicine that contains acetaminophen it is very important for an adult not to take more than 4000 mg from all sources in one day. If you take just a little more than the recommended dose each time, over days or weeks, it can build up in your system and cause liver damage. In fact acetaminophen overdose is a major cause of liver failure. It is even more dangerous if you drink alcohol. People who take more than 3 drinks a day are advised to avoid acetaminophen. If you use Vicodin you should be aware that it contains acetaminophen.

Diphenhydramine, generic for Benadryl, is an antihistamine often used in cold and cough medicines. It is also the sleep inducing ingredient used in PM medications such as Tylenol PM and NyQuil PM. It is for sniffles and sneezes, allergy-like symptoms and also, obviously, it will make you drowsy.

Phenylephrine is a decongestant, it is used to treat nasal congestion, sinus pressure, and congestion of the eustachian tubes in the ears. It works by shrinking dilated blood vessels. This ingredient has replaced pseudo-ephedrine in many OTC medicines. Phenylephrine can raise heart rate and blood pressure. If you are taking any other medicine, OTC, prescription, or herbal, even supplements, please be sure to read the label carefully if you are considering taking anything containing Phenylephrine. If you have a medical condition such as high blood pressure, heart and blood vessel disease, intestinal problems, liver disease, irregular heartbeat, low blood fluid volume, overactive thyroid, diabetes, blood clots or asthma, you should check with a doctor before taking Phenylephrine. I know from personal experience that it can be very bad if you give it to someone suffering an asthma attack.

Guaifenesin is an expectorant, it's the active ingredient in Mucinex. It is also contained in Robitussin and a lot of other OTC cough medicines. It thins the mucus in your chest and throat, making it easier to cough up. I didn't find a lot of warnings associated with this other than that it should not be given to children under 4 years old.

Dextromethorphan is a cough suppressant. If you see DM on the label, that indicates that the medicine contains Dextromethorphan. It works by affecting the signals in the brain that trigger the cough reflex. It should not be used if you have taken an MAOI inhibitor within the past 14 days. Dextromethorphan is also a drug that has sometimes been abused. In high doses it can act as a hallucinogen.

Since Guaifenesin thins mucus and makes it easier to cough up, and Dextromethorphan suppresses the cough reflex, it doesn't seem to make a lot of sense to take them together. It would be better to decide which one is more appropriate for your cough.

I am not a medical professional

and this is not meant to be a complete list of the benefits and dangers of any of these ingredients. It is just an overview of some common OTC medications. When properly used all of these medications can be safe and effective. Please read the label, follow dosing guidelines, and know what your are putting in your body.

Special care should be taken with children and pregnant women. Children should never be given adult medications without a doctors advice.